2011~2015年安徽省妇幼保健院剖宫产率及指征变迁分析

目的 分析安徽省妇幼保健院剖宫产率及剖宫产指征构成的变化,为进一步制定降低剖宫产率的具体措施提供依据.方法 对2011~2015年在安徽省妇幼保健院住院分娩的62 506例孕妇的临床资料进行回顾性分析,统计分析5年间产妇剖宫产指征的构成、剖宫产率的变化、社会因素剖宫产的构成以及围产儿情况.结果 ①2011年安徽省妇幼保健院妇产科剖宫产率为59.30%,2015年为43.90%,2011~2015年剖宫产率呈下降趋势(P<0.01);5年间我院分娩的新生儿NICU入住率无显著变化.②在剖宫产指征的构成方面,2015年剖宫产产妇主要以瘢痕子宫(13.06%)为主,高于2011年(7.01%),差异有统计学意义(P<0.01).2011年剖宫产产妇中主要以社会因素为主(15.47%),2015年为(4.51%),呈现显著下降趋势(P<0.01).③社会因素剖宫产患者中,2015年以认为剖宫产安全方便(30.83%)为主,2011年以不能忍受分娩痛疼(40.02%)为主.结论 2011~2015年安徽省妇幼保健院的总体剖宫产率呈下降趋势,但并没有围生儿发病率及病死率升高;剖宫产指征构成已由原来的社会因素为主,转变为现在的以瘢痕子宫为主.

Analysis of factors affecting cesarean section rate and its indications

Objective To summarize the changes in cesarean section rate and its indications constituted, so as to evaluate the effectiveness of measures to reduce the rate of cesarean section.Methods The clinical data of 62506 pregnant women who were hospitalized in this hospital from 2011 to 2015 were retrospectively analyzed, and the statistical analysis was performed in the composition of maternal cesarean section, the change of cesarean section rate, social factors influencing cesarean section and the condition of perinatal infants.Results ① In 2015, the total cesarean section rate of our hospital was 43.90%, which was lower than the 59.30% in 2011(P<0.01).Whereas, the NICU occupancy rate did not change significantly during the five years.② In terms of the composition of cesarean section indications, the proportion of scar of the uterus occupied 13.06% in 2015, which was higher than that in 2011 (7.01%) with statistical significance(P<0.01).The percentage of social factors behind cesarean section was 15.47% and 4.51% in the year 2011 and 2015, respectively, showing a significant downward trend, and the difference was statistically significant (P<0.01).③For social factors influencing patients with cesarean section, the major concern shifted from pain of delivery in 2011(30.83%) to safety and convenience in cesarean section in 2015(40.02%).Conclusion The overall cesarean section rate of our hospital shows a significant downward trend during the five years, without the increase in perinatal morbidity and mortality.Cesarean section indications in delivery change from the social factors in the past to the scarred uterus at present.